The ketubah is a significant popular form of Jewish ceremonial art. Ketubot have been made in a wide range of designs, usually following the tastes and styles of the era and region in which they are made. Many couples follow the Jewish tradition of hiddur mitzvah which calls for ceremonial objects such as the ketubah to be made as beautiful as possible.

Traditional ketubot are not written in the Hebrew language, but in Aramaic, the lingua franca of Jews at the time ketubot became standardized. This was done in order to make sure the bride and groom understood the contract that was being signed. Many contemporary ketubot have translations into English or other vernacular languages or an accompanying vernacular text. Many Conservative Jews and other non-Orthodox Jews use ketubot written in Hebrew rather than in Aramaic. Others may use Aramaic ketubot but also have an additional official version in Hebrew.

In recent years kettubot have become available in a variety of formats as well as the traditional Aramaic text used by the Orthodox community. Available texts include Conservative text, using the Lieberman clause Reform, Egalitarian and Interfaith texts. Some congregations have texts available for same sex couples too. In addition, Secular Humanist and Anniversary texts are also available today.

In a traditional Jewish wedding ceremony, the ketubah is signed by two witnesses and traditionally read out loud under the chuppah Close family, friends or distant relatives are invited to witness the ketubah, which is considered an honour. The witnesses must be halakhically competent witnesses, and so cannot be a blood relative of the couple.